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Ending AIDS: progress towards the 90–90–90 targets – Global AIDS Update 2017
Joint United Nations Programme on HIV/AIDS (UNAIDS)
July 2017 :: 198 pages
PDF: http://www.unaids.org/sites/default/files/media_asset/Global_AIDS_update_2017_en.pdf

Overview
Ending AIDS: progress towards the 90–90–90 targets, gives a detailed analysis of progress and challenges towards achieving the 90–90–90 targets. The report shows that for the first time the scales have tipped: more than half of all people living with HIV (53%) now have access to HIV treatment and AIDS-related deaths have almost halved since 2005. In 2016, 19.5 million of the 36.7 million people living with HIV had access to treatment, and AIDS-related deaths have fallen from 1.9 million in 2005 to 1 million in 2016. Provided that scale-up continues, this progress puts the world on track to reach the global target of 30 million people on treatment by 2020.

Foreward
When I launched the 90–90–90 targets three years ago, many people thought they were
impossible to reach. Today, the story is very different. Families, communities, cities and
countries have witnessed a transformation, with access to HIV treatment accelerating in
the past three years. A record 19.5 million people are accessing antiretroviral therapy,
and for the first time more than half of all people living with HIV are on treatment. More
countries are paying for HIV treatment themselves. More people living with HIV are
employed, more girls are in school, there are fewer orphans, there is less ill health and less
poverty. Families and communities are feeling more secure.

With science showing that starting treatment as early as possible has the dual benefit of
keeping people living with HIV healthy and preventing HIV transmission, many countries
have now adopted the gold-standard policy of treat all. Our efforts are bringing a strong
return on investment. AIDS-related deaths have been cut by nearly half from the 2005
peak. We are seeing a downward trend in new HIV infections, especially in eastern and
southern Africa, where new HIV infections have declined by a third in just six years. This
good news is a result of the combined effect of a rapid scale-up of treatment and existing
HIV prevention interventions. Moving forward, every additional dollar invested in AIDS will
deliver a US$ 8 return.

But our quest to end AIDS has only just begun. We live in fragile times, where gains can
be easily reversed. The biggest challenge to moving forward is complacency.

Global solidarity and shared responsibility has driven the success we have achieved so
far. This must be sustained. But for several years now, resources for AIDS have remained
stagnant, and we are not on track to reach the US$ 26 billion of investment we need by
Without more domestic investments and international assistance, we cannot push

faster on the Fast-Track. More people will become infected with HIV and lives will be lost.
Without more community health workers, health systems will remain stretched. Without
changing laws, key populations will be left behind.

We must not fail children, women and girls, young people and key populations. We must
engage with men differently. Men are being left behind in the push to 90–90–90, in turn
affecting the lives of women and children.

I remain optimistic. This report clearly demonstrates the power of the 90–90–90 targets
and what can be achieved in a short time. It shows that innovations are possible at every
level—from communities to research laboratories, from villages to cities. It illustrates the
power of political leadership to make the impossible possible.
Michel Sidibé
UNAIDS Executive Director

Press Release
The scales have tipped—UNAIDS announces 19.5 million people on life-saving treatment and AIDS-related deaths halved since 2005
The 90–90–90 targets are galvanizing global action and saving lives. Eastern and southern Africa leading the way in reducing new HIV infections by nearly 30% since 2010—Malawi, Mozambique, Uganda and Zimbabwe have reduced new HIV infection by nearly 40% or more since 2010. Concerted efforts still needed for children, adolescents, men and key populations, and in certain regions.

GENEVA/PARIS, 20 July 2017—UNAIDS has released a new report showing that for the first time the scales have tipped: more than half of all people living with HIV (53%) now have access to HIV treatment and AIDS-related deaths have almost halved since 2005. In 2016, 19.5 million of the 36.7 million people living with HIV had access to treatment, and AIDS-related deaths have fallen from 1.9 million in 2005 to 1 million in 2016. Provided that scale-up continues, this progress puts the world on track to reach the global target of 30 million people on treatment by 2020.

“We met the 2015 target of 15 million people on treatment and we are on track to double that number to 30 million and meet the 2020 target,” said Michel Sidibé, Executive Director of UNAIDS. “We will continue to scale up to reach everyone in need and honour our commitment of leaving no one behind.”

The region showing the most progress is eastern and southern Africa, which has been most affected by HIV and which accounts for more than half of all people living with HIV. Since 2010, AIDS-related deaths have declined by 42%. New HIV infections have declined by 29%, including a 56% drop in new HIV infections among children over the same period, a remarkable achievement resulting from HIV treatment and prevention efforts that is putting eastern and southern Africa on track towards ending its AIDS epidemic.

WHAT’S ON TRACK
90–90–90 progress
The report, Ending AIDS: progress towards the 90–90–90 targets, gives a detailed analysis of progress and challenges towards achieving the 90–90–90 targets. The targets were launched in 2014 to accelerate progress so that, by 2020, 90% of all people living with HIV know their HIV status, 90% of all people with diagnosed HIV are accessing sustained antiretroviral therapy and 90% of all people accessing antiretroviral therapy are virally suppressed.

The report shows that in 2016 more than two thirds (70%) of people living with HIV now know their HIV status. Of the people who know their status, 77% were accessing treatment, and of the people accessing treatment, 82% were virally supressed, protecting their health and helping to prevent transmission of the virus.

Eastern and southern Africa, western and central Europe and North America and Latin America are on track to reach the 90–90–90 targets by 2020. In eastern and southern Africa, 76% of people living with HIV know their HIV status, 79% of people who know their HIV-positive status have access to antiretroviral therapy and 83% of people who are on treatment have undetectable levels of HIV—this equates to 50% of all people living with HIV in eastern and southern Africa with viral suppression. The Caribbean and Asia and the Pacific can also reach the 90–90–90 targets if programmes are further accelerated.

Seven countries have already achieved the 90–90–90 targets—Botswana, Cambodia, Denmark, Iceland, Singapore, Sweden and the United Kingdom of Great Britain and Northern Ireland—and many more are close to achieving it.

“Ending AIDS is possible – it is a shared engagement and aspiration. One that cities can lead while promoting inclusive societies for all,” said Anne Hidalgo, Mayor of Paris…

In 2016 an estimated:
:: 19.5 million people were accessing antiretroviral therapy
:: 36.7 million [30.8 million–42.9 million] people globally were living with HIV
:: 1.8 million [1.6 million–2.1 million] people became newly infected with HIV
:: 1.0 million [830 000–1.2 million] people died from AIDS-related illnesses

WHAT’S OFF TRACK?
Treatment for children living with HIV
Only 43% of children living with HIV have access to antiretroviral therapy, compared to 54% of adults. Ending AIDS also reveals that as many as two thirds of children under two years old are diagnosed late and start treatment with advanced immunodeficiency, resulting in a high mortality rate for children of this age group. More action is needed to diagnose and treat children living with HIV.

Young people are lagging behind
Young people (15–24 years) are lagging behind on multiple fronts—knowledge of HIV, HIV testing, treatment and prevention. Young people continue to be at great risk of HIV infection, especially young women in sub-Saharan Africa. New HIV infections among young women in sub-Saharan Africa are 44% higher than among young men of their age in the region. Around 610 000 new HIV infections occurred among young people aged 15–24 years; 59% of those new infections occurred among young women age 15–24 years.
In Malawi, Zambia and Zimbabwe, half of young people do not know their status and more than half do not have access to HIV treatment. Only 36% of young men and 30% of young women in sub-Saharan Africa had a basic knowledge of how to protect themselves from HIV. Population-based HIV Impact Assessments (PHIAs) conducted in Malawi, Zambia and Zimbabwe, and supported by the United States President’s Emergency Plan for AIDS Relief, found that less than 50% of young people living with HIV were aware of their HIV status, compared to 78% of adults aged 35–59 years.

Men not being reached
The report reveals that less than 50% of young men know how to protect themselves from HIV infection, that men are much less likely to know their HIV status or start treatment than women and that less than 50% of men living with HIV are accessing antiretroviral therapy. Many men who are diagnosed with HIV are diagnosed late and start treatment only when they fall ill, making them much more likely to die of AIDS-related illnesses than women. Deaths from AIDS-related illnesses were 27% lower among women than among men…

MSF/Médecins Sans Frontières [to 22 July 2017]
http://www.doctorswithoutborders.org/news-stories/press/press-releases
Press release
Doctors Without Borders Statement on New UNAIDS Report
July 20, 2017
UNAIDS released a report today that shows a reduction in AIDS-related deaths and states that more than half of all people living with HIV have access to treatment. Unfortunately, this report fails to recognize that sustained support is critical and that many people living with HIV/AIDS—like those in West and Central Africa—remain neglected and continue to suffer needlessly and die silently from AIDS-related diseases and infections. Today’s report finds that there were 1 million AIDS-related deaths last year, compared to 1.9 million in 2005.

Global Fund [to 22 July 2017]
http://www.theglobalfund.org/en/news/?topic=&type=NEWS;&country=
News
New Global Fund Results Show Accelerated HIV Treatment Progress
20 July 2017
GENEVA – Ahead of next week’s International AIDS Society Conference on HIV Science in Paris, France, the Global Fund to Fight AIDS, Tuberculosis and Malaria today announced new results that highlight accelerating progress in providing HIV prevention, treatment and care services.
The results show that 11 million people are receiving antiretroviral therapy for HIV through Global Fund-supported programs, an increase of 19 percent from a year before.
“Our partnership is achieving results on a scale that few of us thought was possible,” said Marijke Wijnroks, Interim Executive Director of the Global Fund. “But we need to do even more. The number of new infections is still too high and, as we continue to expand lifesaving HIV treatments we need a stronger focus on prevention, human rights and gender. Reaching key and vulnerable populations, youth, and adolescent girls and young women is absolutely essential.”
The results, based on data from the end of 2016, also show that programs supported by the Global Fund partnership provided 4.3 million pregnant women with antiretroviral medicines to prevent the transmission of HIV to their unborn children.
This incredible progress is due to the global partnership and commitment of governments, civil society groups, health workers and local and international organizations, along with support from major donors and organizations including the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), UNAIDS and WHO…

NIH  [to 22 July 2017]
http://www.nih.gov/news-events/news-releases
July 20, 2017
NIH-supported scientists elicit broadly neutralizing antibodies to HIV in calves
Unique structure of bovine bNAbs may inform HIV vaccine, therapeutics design.